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Semin Neurol 2020; 40(04): 439-449
DOI: 10.1055/s-0040-1713633
Review Article

Risk Factors for Chronic Traumatic Encephalopathy: A Proposed Framework

Alyssa Phelps
1   Boston University Alzheimer's Disease and CTE Centers, Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
,
Jesse Mez
1   Boston University Alzheimer's Disease and CTE Centers, Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
,
Robert A. Stern
1   Boston University Alzheimer's Disease and CTE Centers, Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
2   Department of Neurosurgery, Boston University School of Medicine, Boston, Massachusetts
3   Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts
,
Michael L. Alosco
1   Boston University Alzheimer's Disease and CTE Centers, Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
› Author Affiliations Acknowledgments This work was supported by grants from the NIH (U01NS086659–01; K23AG046377; K23NS102399; DOD W81XWH1810580, R01AG061028, P30 AG13846–22S2). This publication was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through BU-CTSI Grant Number 1UL1TR001430.
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Abstract

Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative disease that has been neuropathologically diagnosed in contact and collision sport athletes, military veterans, and others with a history of exposure to repetitive head impacts (RHI). Identifying methods to diagnose and prevent CTE during life is a high priority. Timely diagnosis and implementation of treatment and preventative strategies for neurodegenerative diseases, including CTE, partially hinge upon early and accurate risk characterization. Here, we propose a framework of risk factors that influence the neuropathological development of CTE. We provide an up-to-date review of the literature examining cumulative exposure to RHI as the environmental trigger for CTE. Because not all individuals exposed to RHI develop CTE, the direct and/or indirect influence of nonhead trauma exposure characteristics (e.g., age, sex, race, genetics) on the pathological development of CTE is reviewed. We conclude with recommendations for future directions, as well as opinions for preventative strategies that could mitigate risk.

Keywords

chronic traumatic encephalopathy - concussion - subconcussions - repetitive head impacts - risk factors


Publication History

Article published online:
16 July 2020

© 2020. Thieme. All rights reserved.

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